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Trixlm

Lab Results Negative. Everything Else Says Positive. Celiac?

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I really need some insight, help, & advice... Warning this is long ;(

So I've suffered from depression in the past & severe fatigue for as long as I can remember. I never took medication for depression. I never used drugs or smoked ever, rarely drink alcohol. I absolutely LOVE sleep. It is my best friend. I am a 23 year old femal at 5'2 and typically 105 lbs. I've always been healthy overall.

The past 7 years I've been more active. I would jog/ run for the most part about 3 times a week.

In 2009 I was having severe chest pains while eating at a birthday party and I thought I was having a heart attack. I was rushed to the hospital and it turned out that I had an esophageal tear from acid reflux and was admitted to the hospital. I was waiting to eventually have surgery but luckily the doctors suggested to allow it to heal on its own under their watch to avoid surgery. I was dx with gerd and was questioned if I was bulimic!!! I was angry and offended but admitted to the fact that I get heartburn pain often and would sometimes vomit because of it. But I am naturally thin and had no reason or desire to that even being the last thing on my mind. I then just watched what I ate and stopped the Prilosec prescribed after a months use.

About 4 years ago I adopted the whole "fitness hype" when bodybuilding was becoming more mainstream popular. I ate more whole foods with exceptions of those "cheat meals." I had an iud (sorry tmi) placed a year after.

Towards my year anniversary of iud placement my symptoms of fatigue worsened and my acne, mood, depression increased. I consulted with my primary care physician about my concerns and was finally put on lexapro. I gave it 6 months and decided it was not for me. During that visit she ordered a comprehensive panel, CBC, c reactive, tsh, for blood work. Everything was fine ruling out anemia or thyroid issues that could cause my problems but I had borderline low mcv, mean platelet volume, mean corpulusculur hgb, and extremely vitamin d deficient. I was instructed to take a high dosage of vitamin d after that...

I then researched iud complications and that it might have been contributing to my condition. Had it removed and went completely hormone free. I decided throughout that year of suffering that I would "better myself" even more. I smiled more often and joined yoga classes, scheduled a more balanced exercise regimen of 3-5x a week, and ate more "healthy" foods (ie: every grain, whole, wheat, pastas, etc.). But I found I just wasn't getting any better.

The past six months I started to journal my food intake through my myfitnesspal for vitamin/macro nutrient purposes and noted my mood/reactions/feelings throughout my eating habits and activities. I consumed more whole foods and added vitamins and excluded any supplements containing fillers, artificial sweeteners... I didn't notice much of a difference. And once again increased my intake of "healthy" alternatives of wheat products.

I still couldn't get a hand on why I was getting worst even though I was getting "better." I searched everything and one day I ordered a jimmy johns sandwich. (I love them!) Had nothing but turkey, lettuce, sprouts, tomatoes, no cheese, no mayo, served on their wheat bread. I ate half and immediately had a distended belly. I had severe stomach pains, nausea, bubbly gas, burping, indigestion, and vomited shortly after. My co worker was there during this episode and joked with me that my tiny body looked like I was 8 months pregnant and asked if I was ok. I had a headache, felt exhausted, and took a nap when I got home. Thankfully that was a Friday and I slept nearly all day the next.

I got to thinking about how my co worker reacted and how all of my coworkers always joked about how gassy and bloated I always was. I'm a jokester so I was always open about talking about my constant diarrhea issues and burping outloud. I just never took it seriously or brought it to my physicians attention because I figured they were normal symptoms because thats what happens when you eat?

I was so discouraged at that point which led me to googling every single symptom I had. I started coming across symptoms of food allergies because of the gi reactions I would have after meals. I looked back at my notes and realized that it matched like a puzzle piece to celiac/gluten allergy symptoms. I had always overlooked this but I have always been bloated, gassy, having diarrhea, mood swings, horrible memory, fatigue, aches, etc the list goes on! What stood out so strongly was the fact that after certain meals was when I would have the episode the strongest. I did my own experiment of excluding gluten completely. I immediately felt better. My acne was a huge indication because my cystic acne stopped and the little breakouts I would have would clear overnight. I had energy, I stopped taking naps at work, I lost 10 lbs(I was 120), tummy was flattest its ever been, and the bloating subsided significantly. But I was still slightly fatigued through it all and decided to make an appointment.

Last week my primary care wasn't available so I saw someone new. I brought up valid concerns that linked to celiacs and he brushed it off and said that there's no way a healthy 23 year old like me would have these problems. He started going over my medical history then went into a spiel about reassuring me I don't have cancer. It was such a waste of time and irritating because I felt that he had a preconceived idea of me that I might've suspected cancer given the fact that I work at the cancer center!!! I never even brought up anything to do with cancer! At the end of it all he felt that my depression was a manifestation of my fatigue even though I wasnt necessarily depressed and to trial different meds to see which would work. He ordered a CBC and celiacs panel but they all came out negative.

Keep in mind he spent 10 minutes with me and I brought up my concern that I had been avoiding gluten for 6 months unknowingly through most healthy eating and the past 3 months nearly gluten free and last month 100% gluten free. Also my gluten free vegan protein supplements contain glutamine in addition to glutamine supplement, I have been taking probiotics, and fish oil which I've read sped the healing process if in fact this is celiacs. I pleaded that this would all probably affect results and he said if in fact I had gluten allergies/celiacs that it didn't matter and results would be positive.... I just wanted to scream...

I'm not doing this because of a trend. I never even knew of this until I went crazy for answers. And I definitely wouldn't waste my time/money for a placebo effect. I am tired. I feel like crap and I'm sick and tired of being sick and tired. It's a physically and mentally painful feeling to go through my 20s knowing there is something wrong with me and that no one can figure it out. I'm hitting dead ends and I want to know as someone who has celiac or dealing with a family member, misdiagnosis, etc what you think. My mom btw is very anemic and diabetes runs in my family. My grandmother passed away from breast cancer. I love pasta, breads, I'm your typical carboholic. But I have no problems like this when I eat white or brown rice carbs. Small amounts of wheat makes me very sick. And I wake up sometimes in the middle of the night because my feet and hands tingle like they're dead and I swore ghosts slept on me even when I slept straight on my back. I get random patches of hives. Raised bumps and sometimes blister fluid filled looking, I ignored them and thought they may have been bug bites-they were extremely itchy and go away after a few days...My weight fluctuates quite a bit.. I don't know what else to add besides the fact that its just straight misery dealing with this and I smile through it as much as I can. I just want to make sure I'm doing the right things and not diagnose myself without further evaluation and valid information. I will list my blood work below. Anything helps. I can't wait to hear from you all!!!

St stands for standard range. I apologize f it's sloppy. It's a lot to type lol! I only posted results that had possible significant value and of course the celiac panel. My comprehensive, glucose, and tsh have beautiful numbers so I didn't add them.

Celiac panel---

Immunoglobulin A- 286 St 66-436

Tt IGA- 4 St 0-19

PEPT IGA- 4 St 0-19

CBC---

White count-7.5 st 4-11.1

Red count-4.75 st 4.18-5.64

Hemoglobin-14.3 st 12.1-16.3

Hematocrit-43 st 35.7-46.7

MCV-90 st 80-100

MC HGB-30.1 st 27.5-35.1

MC HGB CONC- 33.2 st 32-36

Platelet-303 st 150-400

MPV-9.1 st 9.6-12.8

Vitamin D-15 st 30-100

Sed rate-3 st 0-20

C reac- <.5 st <1.0

A1C-4.7 st 4-6

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Welcome...

 

A bit tired here...others will add more info, but

 

Your Vitamin D is extremely low -- indicative of malabsorption.

 

The celiac tests you list are not complete.

 

assuming the Peptide test you list is DGP IGA.

 

Missing are tTG-IgG, DGP-IgG and EMA-IgA -- I'm tired so perhaps you listed Total Serum IgA...but do double check

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Hi there.  I will pick up from the exhausted Lisa.

 

The immunoglubulin is your total serum IgA.  This is normal, as are the other celiac tests performed.  But this is only to be expected if you had not been eating gluten prior to testing.  It is surprising how many doctors do not know this :huh:   Add in the L-glutamine and probiotics and you are well on your way to healing.  Testing at this point is pretty much a nonstarter unless you want to go back and regluten yourself for 6-8 weeks.

 

Your tingling hands are probably a neurological manifestation of gluten, and the fluid-filled bumps are probably DH, the major skin manifestion of gluten intolerance. 

 

You seem to be someone very much in touch with your own body and how it reacts and from reading your account it seems pretty obvious to me that you are gluten intolerant.  Whether or not you would test positive for celiac if you were to go back to eating gluten I do not know.  Regardless, the treatment for any kind of gluten intolerance is strict avoidance of gluten.  There are those who believe it is almost heretical to go gluten free without being tested, but I did what you did, in total exasperation, and have never looked back at that decision and would never consider poisoning myself again to try to get a formal diagnosis.  You must make your own decision.

 

Your vitamin D is massively low and needs immediate and substantial supplementation of Vitamin D3 before you develop osteoporosis.  I would try to get a prescription from your doctor for 50,000 units every week for at least two months, and 5,000 units a day on top of that.  The way my doctor explained it to me, with your tank so empty, if you take the recommended supplementation it is barely enough to get you to the next gas station to buy another gallon.  What you need is to fill your tank first, and then keep topping it up until you can absorb it from your foods.  With the summer coming on spend some time in the sun too.

 

If you were not checked for other nutrient levels, you should be.  Vitamins A, B, E and K, folate, iron/ferritin, magnesium, copper, zinc.  You could be low in any of these.

 

Welcome to the forum and let us know how else we can be of help. :)

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Yep...exactly what she said!

Welcome :)

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All looks like excellent advice to me.

Lots of us struggle to get diagnosed, but the proof for me is in how much better I am without gluten, as you have found. Sadly, yours is not the only doctor with misinformation.

I had problems with hormones, and was way better off the pill.

The good news is you have worked it out while you are still young, and hopefully will see big improvements. You might need to be patient, sometimes there are a few more bits of jigsaw to get in place.

Stick around, ask questions, rant, whatever. You just found some buddies to help you out. Welcome :)

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Vitamin D, just go to the health food store and get the 50,000 unit Vitamin D3.  The kind from the doc is going to be D2, don't want that.  one every 5-7 days and retest in ~ 3 months.

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Welcome...

 

A bit tired here...others will add more info, but

 

Your Vitamin D is extremely low -- indicative of malabsorption.

 

The celiac tests you list are not complete.

 

assuming the Peptide test you list is DGP IGA.

 

Missing are tTG-IgG, DGP-IgG and EMA-IgA -- I'm tired so perhaps you listed Total Serum IgA...but do double check

Thank you much Lisa for your effort! I did post real late so I understand :) the #286 is total iga and I the other two are the only others he ordered :( my doctor put me on only 2,000 iu of vitamin d3 so I'm still taking that...

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Hi there.  I will pick up from the exhausted Lisa.

 

The immunoglubulin is your total serum IgA.  This is normal, as are the other celiac tests performed.  But this is only to be expected if you had not been eating gluten prior to testing.  It is surprising how many doctors do not know this :huh:   Add in the L-glutamine and probiotics and you are well on your way to healing.  Testing at this point is pretty much a nonstarter unless you want to go back and regluten yourself for 6-8 weeks.

 

Your tingling hands are probably a neurological manifestation of gluten, and the fluid-filled bumps are probably DH, the major skin manifestion of gluten intolerance. 

 

You seem to be someone very much in touch with your own body and how it reacts and from reading your account it seems pretty obvious to me that you are gluten intolerant.  Whether or not you would test positive for celiac if you were to go back to eating gluten I do not know.  Regardless, the treatment for any kind of gluten intolerance is strict avoidance of gluten.  There are those who believe it is almost heretical to go gluten free without being tested, but I did what you did, in total exasperation, and have never looked back at that decision and would never consider poisoning myself again to try to get a formal diagnosis.  You must make your own decision.

 

Your vitamin D is massively low and needs immediate and substantial supplementation of Vitamin D3 before you develop osteoporosis.  I would try to get a prescription from your doctor for 50,000 units every week for at least two months, and 5,000 units a day on top of that.  The way my doctor explained it to me, with your tank so empty, if you take the recommended supplementation it is barely enough to get you to the next gas station to buy another gallon.  What you need is to fill your tank first, and then keep topping it up until you can absorb it from your foods.  With the summer coming on spend some time in the sun too.

 

If you were not checked for other nutrient levels, you should be.  Vitamins A, B, E and K, folate, iron/ferritin, magnesium, copper, zinc.  You could be low in any of these.

 

Welcome to the forum and let us know how else we can be of help. :)

Hi neroli! I'm excited to hear from you. So now what I am going to deal with is to either decide to maintain gluten-free or get that formal diagnosis... Everyone including friends don't really understand what I'm going through and not taking it seriously because I have nothing to back my claims of gluten allergy... I even had a friend telling me there's no such thing as gluten intolerance unless its full blown celiacs ;( I may be willing to go through the pain if that's what it takes... I have a follow up appointment next month and was hoping to be referred to a gi specialist. I'm only taking 2,000 iu of vitamin d3 as instructed so far and will bring it up to my pcp next month. Even though I've gone gluten free for a while I still feel tired. I have more energy, no bloating, still a bit of diarrhea, but lost weight and slowly getting over that "not feeling well" feeling. And I am also heat/temperature change sensitive. I would like to stay off but I fear rejection from my peers that its just all in my head. Are those post gluten-free symptoms normal?

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All looks like excellent advice to me.

Lots of us struggle to get diagnosed, but the proof for me is in how much better I am without gluten, as you have found. Sadly, yours is not the only doctor with misinformation.

I had problems with hormones, and was way better off the pill.

The good news is you have worked it out while you are still young, and hopefully will see big improvements. You might need to be patient, sometimes there are a few more bits of jigsaw to get in place.

Stick around, ask questions, rant, whatever. You just found some buddies to help you out. Welcome :)

Yes I definitely feel better without the pill... There's health care vs medicine care and if you can find the root of the problems I am a strong believer that you can heal without synthetic treatment :) I am wanting a proper diagnosis. I know that's a tough thing to ask for considering how its so over looked... I am seeing dramatic improvements but I still don't feel well even though I have more energy. I have a lot of decisions to make :( I'm so excited to have found support here its all a bit clear now, thank you :)

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When you stop eating gluten it is not like turning off the faucet and presto! no more water :)   Well, actually, it is a bit like water,  because while there may be no more gluten, the past effects linger on.  Just as with too much water there is flood damage, with too much gluten in a gluten intolerant there is an aftermath.  The autoantibodies can take a while to leave, but even after they have gone the havoc they have wreaked remains to be cleared up, the healing process.  Depending on the degree of damage and your own body's healing ability (as well as how perfectly you manage your diet) it can take from six months to a couple of years to totally heal.  For some of us even longer. :(   Yes, those post-gluten-free symptoms are perfectly normal.  Lisa is one who is very heat sensitive.  I often imagine her madly tossing off clothes whilst others are sitting shivering :D

 

While it is nice that our friends care about us, it is annoying when they tell us what problems we can and cannot have, what we can and cannot eat, when we know better than they what our bodies need.  I personally don't believe peer pressure should make our decisions for us, but it can be very strong :rolleyes:

 

Of course the GI is going to want to do (if he is worth his salt) a full celiac panel,

 

Anti-Gliadin (AGA) IgA
Anti-Gliadin (AGA) IgG
Anti-Endomysial (EMA) IgA
Anti-Tissue Transglutaminase (tTG) IgA
Deamidated Gliadin Peptide (DGP) IgA and IgG
Total Serum IgA


and then most probably an endoscopy with biopsy.  And for these tests you will need to have been eating a regular gluten diet.  The estimate of the amount of time needed on such a diet varies with the person making the estimate.  But with your strongly gluten free status I would guess 6-8 weeks of at least the equivalent of a couple of slices of bread per day prior to testing.  So the decision about testing needs to be made fairly quickly.  You could still go ahead with the biopsy to rule out any other problems if you wished.

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Trixim,  Hi!

 

I am coming from a super-sensitive viewpoint

 

Feeling for you.  I know the feeling of the struggle to just feel normal and the body's lack of response.  My last 6 years I've spent taking mega doses of supplements, but all the while not knowing about gluten!  I can relate to people around not understanding.  I also try to act normal/content, but oftentimes fail miserably  Did you have brain fog too?  I didn't know it until mine cleared!  I did call it fatigue, though.

 

.  I learned 11 months ago about my problem with gluten.  I still was eating stuff I was intolerant to.  Yet, I do feel better.  Friends and family are starting to come around.  I have been given hope.

 

I hope you will have hope and that you will get well soon  ***

It sounds like my celiac in the above respects,

Diana

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lol....as usual Neroli is very wise and spot on -- including her image of me shedding clothing -- more than once I have had very strange looks as I shed layers down to my sport tank top in cool or even cold weather -- lots of layers is the way I regulate my temperature -- right now I am wearing my all important tank as I never know when I'll need to strip -- then a long sleeve tee, thin lycra type jacket, polertec vest and polartec jacket -- on my walk I will strip to any combo of the above as it is still about 58 outside, but once I start moving my body cannot cool itself -- the easiest way to describe it is I have a broken thermostat -- can't warm up when I get cold and can't cool from exercise or warm environment -- really it has to do with the amount of histamine the body generates.

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I thought as usual that I was just crazy! I live in Denver & I cannot stand the cold but at the same time I am more heat sensitive than anything.  Often times I wake up in the middle of the night sweating then I'd have to shed completely with my air purifier fan blowing straight at me, then by the morning as I get ready for work I start to burn up and even if it's cold outside I'll be in a plain t shirt and get into work almost sweating.  I'm sure the stress that my body feels responds through the sweating, you feel like death... then my blood pressure would drop and I would get really light headed. My body temperature is normally 97.0 or below. Do you have that low of a temp as well? Do you still have to regulate your body temp :P? And I love 40-60 degress outdoors lol anything lower or higher my body freaks out. I could seriously just stroll around naked and have a sheet around if I get a temp drop. It's like i'm going through menopause as what my co workers would say :(

 

lol....as usual Neroli is very wise and spot on -- including her image of me shedding clothing -- more than once I have had very strange looks as I shed layers down to my sport tank top in cool or even cold weather -- lots of layers is the way I regulate my temperature -- right now I am wearing my all important tank as I never know when I'll need to strip -- then a long sleeve tee, thin lycra type jacket, polertec vest and polartec jacket -- on my walk I will strip to any combo of the above as it is still about 58 outside, but once I start moving my body cannot cool itself -- the easiest way to describe it is I have a broken thermostat -- can't warm up when I get cold and can't cool from exercise or warm environment -- really it has to do with the amount of histamine the body generates.

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YES brain fog had been one of my worsening symptoms. I would joke around and say that "my brain is so gassy because I keep having brain farts"... lol along with what I knew deep down was going on with my tummy :(  It's definitely getting better... I had the worst short term memory where I couldn't remember one thing I looked at or if I memorized barely 6 numbers to write down I would write it in a scrambled or almost dyslexic order.  I would stumble on everything, drop everything, walk somewhere I wasn't supposed to. trip on my own shoes. I was horrible at responding to texts and emails. I would think something but not say it and wonder why the person I was mind speaking to wouldn't respond LOL weird things like that... I was always so confused and would be so hard on myself that maybe I'm lazy and careless but my brain to body connection was so bad I was flimsy it was embarassing :blink:  I now have hope to get better and I get excited to jump on the forum everyday. Everyone here is so supportive its such a wonderful community... Thanks Diana I wish the same for you as well :lol:

 

 

Trixim,  Hi!

 

I am coming from a super-sensitive viewpoint

 

Feeling for you.  I know the feeling of the struggle to just feel normal and the body's lack of response.  My last 6 years I've spent taking mega doses of supplements, but all the while not knowing about gluten!  I can relate to people around not understanding.  I also try to act normal/content, but oftentimes fail miserably  Did you have brain fog too?  I didn't know it until mine cleared!  I did call it fatigue, though.

 

.  I learned 11 months ago about my problem with gluten.  I still was eating stuff I was intolerant to.  Yet, I do feel better.  Friends and family are starting to come around.  I have been given hope.

 

I hope you will have hope and that you will get well soon  ***

It sounds like my celiac in the above respects,

Diana

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I've been so disciplined it's becoming habit to steer away from certain products and I use a few handy apps on my iphone to scan items as well :D  I respect your decision to go without diagnosing I feel its pretty evident that these severe reactions could be anything but gluten... I've been contemplating going gluten free without the dx because i'm having a tough time even choosing to eat it.  I naturally just go for an alternative and i'm so in fear of a reaction since they haven't completely subsided that I just won't have it anymore.  It seems once you figure things out its better to keep getting better rather than taking 10 steps back to make wasteful visits to misinformed docs... Still want to get my other vitamins you mentioned checked so I can start supplementing what other deficiencies I may have.  That's a long time for such big amounts of gluten, it makes me nervous thinking about it because I still have plenty of symptoms subsiding.  It's possible to have negative results and have post symptoms but still have antibodies?  

 

When you stop eating gluten it is not like turning off the faucet and presto! no more water :)   Well, actually, it is a bit like water,  because while there may be no more gluten, the past effects linger on.  Just as with too much water there is flood damage, with too much gluten in a gluten intolerant there is an aftermath.  The autoantibodies can take a while to leave, but even after they have gone the havoc they have wreaked remains to be cleared up, the healing process.  Depending on the degree of damage and your own body's healing ability (as well as how perfectly you manage your diet) it can take from six months to a couple of years to totally heal.  For some of us even longer. :(   Yes, those post-gluten-free symptoms are perfectly normal.  Lisa is one who is very heat sensitive.  I often imagine her madly tossing off clothes whilst others are sitting shivering :D

 

While it is nice that our friends care about us, it is annoying when they tell us what problems we can and cannot have, what we can and cannot eat, when we know better than they what our bodies need.  I personally don't believe peer pressure should make our decisions for us, but it can be very strong :rolleyes:

 

Of course the GI is going to want to do (if he is worth his salt) a full celiac panel,

 

Anti-Gliadin (AGA) IgA
Anti-Gliadin (AGA) IgG
Anti-Endomysial (EMA) IgA
Anti-Tissue Transglutaminase (tTG) IgA
Deamidated Gliadin Peptide (DGP) IgA and IgG
Total Serum IgA


and then most probably an endoscopy with biopsy.  And for these tests you will need to have been eating a regular gluten diet.  The estimate of the amount of time needed on such a diet varies with the person making the estimate.  But with your strongly gluten free status I would guess 6-8 weeks of at least the equivalent of a couple of slices of bread per day prior to testing.  So the decision about testing needs to be made fairly quickly.  You could still go ahead with the biopsy to rule out any other problems if you wished.

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.  It's possible to have negative results and have post symptoms but still have antibodies?  

 

There are posters on this board who have returned for a six-month checkup with their doctor and still have positive blood tests for antibodies.  While the numbers have usually markedly declined, they are sometimes accused of not following the diet corrrectly because the antibodies are still active.  Doctors often bully them, tossing the refractory sprue diagnosis at them, but we always tell them, as long as the numbers are continuing to go down not to worry.  Even after a year, in some people whose numbers have been very high, the tests are still in the positive range.  Very few people actually have refractory disease; they just heal slower and sometimes they are the super sensitives to gluten who have to be stricter than the rest of us with the diet.  Some have to eliminate all processed foods altogether because the food  tests for gluten free are not sensitive enough to pick up very low levels (under 5ppm) of gluten.  A member who uses the screen name dillettantesteph is one of these.  These people who still have high antibody levels do still have symptoms.  But if you personally ever had autoimmune antibodies (i.e., celiac and not gluten intolerant) you have shed them already through your dietary elimination of gluten.  Research is still ongoing as to how to test someone who is gluten intolerant but not celiac and therefore does not have these antigliadin antibodies;  i.e., to find a marker which characterizes the condition.   But because of your gluten free status you may not have this marker either by now if there were one.  Just a very long-winded way of saying that healing does not take place immediately :P , whether celiac or not, and that even in the absence of antibodies there is still damage for your body's road crew to work on before you become completely whole again.   I am five years gluten free and still living on the knife edge, hoping my  rheumatoid symptoms stay at bay and that I can ditch my Humira totally (I have used it for only two separate months out of the last 18 or so months, last time in November last year.)  While all my joints have recovered I occasionally get flares of that electrical-type exruciating pain in my fingers and toes, now down to every six months or so or perhaps, we can hope, now gone forever. :rolleyes: My rheumatologist in U.S. does not believe in a dietary connection with RA but is at a loss to understand how I can go without treatment for such long periods.  Certainly it could not be because of my diet :blink:

 

I would be totally supportive of you not further poisoning yourself to satisfy some doctor's craving for certainty, so long as you do not need that certainty for yourself, also.  You must look inside yourself for that answer.

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My results were much the same after 6 months of gluten-free.  Now I know when I eat something I should not by accident, or am weak and think just one bite.  That is why I am here today.  Good luck you will feel better I know.

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    That message, which is transmitted with help from a chemical messenger called acetylcholine, seems to encourage the gut to shift against inflammation, say the scientists.
    In patients who drank water with baking soda for two weeks, immune cells called macrophages, shifted from primarily those that promote inflammation, called M1, to those that reduce it, called M2. "The shift from inflammatory to an anti-inflammatory profile is happening everywhere," O'Connor says. "We saw it in the kidneys, we saw it in the spleen, now we see it in the peripheral blood."
    O'Connor hopes drinking baking soda can one day produce similar results for people with autoimmune disease. "You are not really turning anything off or on, you are just pushing it toward one side by giving an anti-inflammatory stimulus," he says, in this case, away from harmful inflammation. "It's potentially a really safe way to treat inflammatory disease."
    The research was funded by the National Institutes of Health.
    Read more at: Sciencedaily.com

    Jefferson Adams
    Celiac.com 06/18/2018 - Celiac disease has been mainly associated with Caucasian populations in Northern Europe, and their descendants in other countries, but new scientific evidence is beginning to challenge that view. Still, the exact global prevalence of celiac disease remains unknown.  To get better data on that issue, a team of researchers recently conducted a comprehensive review and meta-analysis to get a reasonably accurate estimate the global prevalence of celiac disease. 
    The research team included P Singh, A Arora, TA Strand, DA Leffler, C Catassi, PH Green, CP Kelly, V Ahuja, and GK Makharia. They are variously affiliated with the Division of Gastroenterology and Hepatology, Beth Israel Deaconess Medical Center, Boston, Massachusetts; Lady Hardinge Medical College, New Delhi, India; Innlandet Hospital Trust, Lillehammer, Norway; Centre for International Health, University of Bergen, Bergen, Norway; Division of Gastroenterology and Hepatology, Beth Israel Deaconess Medical Center, Boston, Massachusetts; Gastroenterology Research and Development, Takeda Pharmaceuticals Inc, Cambridge, MA; Department of Pediatrics, Università Politecnica delle Marche, Ancona, Italy; Department of Medicine, Columbia University Medical Center, New York, New York; USA Celiac Disease Center, Columbia University Medical Center, New York, New York; and the Department of Gastroenterology and Human Nutrition, All India Institute of Medical Sciences, New Delhi, India.
    For their review, the team searched Medline, PubMed, and EMBASE for the keywords ‘celiac disease,’ ‘celiac,’ ‘tissue transglutaminase antibody,’ ‘anti-endomysium antibody,’ ‘endomysial antibody,’ and ‘prevalence’ for studies published from January 1991 through March 2016. 
    The team cross-referenced each article with the words ‘Asia,’ ‘Europe,’ ‘Africa,’ ‘South America,’ ‘North America,’ and ‘Australia.’ They defined celiac diagnosis based on European Society of Pediatric Gastroenterology, Hepatology, and Nutrition guidelines. The team used 96 articles of 3,843 articles in their final analysis.
    Overall global prevalence of celiac disease was 1.4% in 275,818 individuals, based on positive blood tests for anti-tissue transglutaminase and/or anti-endomysial antibodies. The pooled global prevalence of biopsy-confirmed celiac disease was 0.7% in 138,792 individuals. That means that numerous people with celiac disease potentially remain undiagnosed.
    Rates of celiac disease were 0.4% in South America, 0.5% in Africa and North America, 0.6% in Asia, and 0.8% in Europe and Oceania; the prevalence was 0.6% in female vs 0.4% males. Celiac disease was significantly more common in children than adults.
    This systematic review and meta-analysis showed celiac disease to be reported worldwide. Blood test data shows celiac disease rate of 1.4%, while biopsy data shows 0.7%. The prevalence of celiac disease varies with sex, age, and location. 
    This review demonstrates a need for more comprehensive population-based studies of celiac disease in numerous countries.  The 1.4% rate indicates that there are 91.2 million people worldwide with celiac disease, and 3.9 million are in the U.S.A.
    Source:
    Clin Gastroenterol Hepatol. 2018 Jun;16(6):823-836.e2. doi: 10.1016/j.cgh.2017.06.037.

    Jefferson Adams
    Celiac.com 06/16/2018 - Summer is the time for chips and salsa. This fresh salsa recipe relies on cabbage, yes, cabbage, as a secret ingredient. The cabbage brings a delicious flavor and helps the salsa hold together nicely for scooping with your favorite chips. The result is a fresh, tasty salsa that goes great with guacamole.
    Ingredients:
    3 cups ripe fresh tomatoes, diced 1 cup shredded green cabbage ½ cup diced yellow onion ¼ cup chopped fresh cilantro 1 jalapeno, seeded 1 Serrano pepper, seeded 2 tablespoons lemon juice 2 tablespoons red wine vinegar 2 garlic cloves, minced salt to taste black pepper, to taste Directions:
    Purée all ingredients together in a blender.
    Cover and refrigerate for at least 1 hour. 
    Adjust seasoning with salt and pepper, as desired. 
    Serve is a bowl with tortilla chips and guacamole.

    Dr. Ron Hoggan, Ed.D.
    Celiac.com 06/15/2018 - There seems to be widespread agreement in the published medical research reports that stuttering is driven by abnormalities in the brain. Sometimes these are the result of brain injuries resulting from a stroke. Other types of brain injuries can also result in stuttering. Patients with Parkinson’s disease who were treated with stimulation of the subthalamic nucleus, an area of the brain that regulates some motor functions, experienced a return or worsening of stuttering that improved when the stimulation was turned off (1). Similarly, stroke has also been reported in association with acquired stuttering (2). While there are some reports of psychological mechanisms underlying stuttering, a majority of reports seem to favor altered brain morphology and/or function as the root of stuttering (3). Reports of structural differences between the brain hemispheres that are absent in those who do not stutter are also common (4). About 5% of children stutter, beginning sometime around age 3, during the phase of speech acquisition. However, about 75% of these cases resolve without intervention, before reaching their teens (5). Some cases of aphasia, a loss of speech production or understanding, have been reported in association with damage or changes to one or more of the language centers of the brain (6). Stuttering may sometimes arise from changes or damage to these same language centers (7). Thus, many stutterers have abnormalities in the same regions of the brain similar to those seen in aphasia.
    So how, you may ask, is all this related to gluten? As a starting point, one report from the medical literature identifies a patient who developed aphasia after admission for severe diarrhea. By the time celiac disease was diagnosed, he had completely lost his faculty of speech. However, his speech and normal bowel function gradually returned after beginning a gluten free diet (8). This finding was so controversial at the time of publication (1988) that the authors chose to remain anonymous. Nonetheless, it is a valuable clue that suggests gluten as a factor in compromised speech production. At about the same time (late 1980’s) reports of connections between untreated celiac disease and seizures/epilepsy were emerging in the medical literature (9).
    With the advent of the Internet a whole new field of anecdotal information was emerging, connecting a variety of neurological symptoms to celiac disease. While many medical practitioners and researchers were casting aspersions on these assertions, a select few chose to explore such claims using scientific research designs and methods. While connections between stuttering and gluten consumption seem to have been overlooked by the medical research community, there is a rich literature on the Internet that cries out for more structured investigation of this connection. Conversely, perhaps a publication bias of the peer review process excludes work that explores this connection.
    Whatever the reason that stuttering has not been reported in the medical literature in association with gluten ingestion, a number of personal disclosures and comments suggesting a connection between gluten and stuttering can be found on the Internet. Abid Hussain, in an article about food allergy and stuttering said: “The most common food allergy prevalent in stutterers is that of gluten which has been found to aggravate the stutter” (10). Similarly, Craig Forsythe posted an article that includes five cases of self-reporting individuals who believe that their stuttering is or was connected to gluten, one of whom also experiences stuttering from foods containing yeast (11). The same site contains one report of a stutterer who has had no relief despite following a gluten free diet for 20 years (11). Another stutterer, Jay88, reports the complete disappearance of her/his stammer on a gluten free diet (12). Doubtless there are many more such anecdotes to be found on the Internet* but we have to question them, exercising more skepticism than we might when reading similar claims in a peer reviewed scientific or medical journal.
    There are many reports in such journals connecting brain and neurological ailments with gluten, so it is not much of a stretch, on that basis alone, to suspect that stuttering may be a symptom of the gluten syndrome. Rodney Ford has even characterized celiac disease as an ailment that may begin through gluten-induced neurological damage (13) and Marios Hadjivassiliou and his group of neurologists and neurological investigators have devoted considerable time and effort to research that reveals gluten as an important factor in a majority of neurological diseases of unknown origin (14) which, as I have pointed out previously, includes most neurological ailments.
    My own experience with stuttering is limited. I stuttered as a child when I became nervous, upset, or self-conscious. Although I have been gluten free for many years, I haven’t noticed any impact on my inclination to stutter when upset. I don’t know if they are related, but I have also had challenges with speaking when distressed and I have noticed a substantial improvement in this area since removing gluten from my diet. Nonetheless, I have long wondered if there is a connection between gluten consumption and stuttering. Having done the research for this article, I would now encourage stutterers to try a gluten free diet for six months to see if it will reduce or eliminate their stutter. Meanwhile, I hope that some investigator out there will research this matter, publish her findings, and start the ball rolling toward getting some definitive answers to this question.
    Sources:
    1. Toft M, Dietrichs E. Aggravated stuttering following subthalamic deep brain stimulation in Parkinson’s disease--two cases. BMC Neurol. 2011 Apr 8;11:44.
    2. Tani T, Sakai Y. Stuttering after right cerebellar infarction: a case study. J Fluency Disord. 2010 Jun;35(2):141-5. Epub 2010 Mar 15.
    3. Lundgren K, Helm-Estabrooks N, Klein R. Stuttering Following Acquired Brain Damage: A Review of the Literature. J Neurolinguistics. 2010 Sep 1;23(5):447-454.
    4. Jäncke L, Hänggi J, Steinmetz H. Morphological brain differences between adult stutterers and non-stutterers. BMC Neurol. 2004 Dec 10;4(1):23.
    5. Kell CA, Neumann K, von Kriegstein K, Posenenske C, von Gudenberg AW, Euler H, Giraud AL. How the brain repairs stuttering. Brain. 2009 Oct;132(Pt 10):2747-60. Epub 2009 Aug 26.
    6. Galantucci S, Tartaglia MC, Wilson SM, Henry ML, Filippi M, Agosta F, Dronkers NF, Henry RG, Ogar JM, Miller BL, Gorno-Tempini ML. White matter damage in primary progressive aphasias: a diffusion tensor tractography study. Brain. 2011 Jun 11.
    7. Lundgren K, Helm-Estabrooks N, Klein R. Stuttering Following Acquired Brain Damage: A Review of the Literature. J Neurolinguistics. 2010 Sep 1;23(5):447-454.
    8. [No authors listed] Case records of the Massachusetts General Hospital. Weekly clinicopathological exercises. Case 43-1988. A 52-year-old man with persistent watery diarrhea and aphasia. N Engl J Med. 1988 Oct 27;319(17):1139-48
    9. Molteni N, Bardella MT, Baldassarri AR, Bianchi PA. Celiac disease associated with epilepsy and intracranial calcifications: report of two patients. Am J Gastroenterol. 1988 Sep;83(9):992-4.
    10. http://ezinearticles.com/?Food-Allergy-and-Stuttering-Link&id=1235725 
    11. http://www.craig.copperleife.com/health/stuttering_allergies.htm 
    12. https://www.celiac.com/forums/topic/73362-any-help-is-appreciated/
    13. Ford RP. The gluten syndrome: a neurological disease. Med Hypotheses. 2009 Sep;73(3):438-40. Epub 2009 Apr 29.
    14. Hadjivassiliou M, Gibson A, Davies-Jones GA, Lobo AJ, Stephenson TJ, Milford-Ward A. Does cryptic gluten sensitivity play a part in neurological illness? Lancet. 1996 Feb 10;347(8998):369-71.

    Jefferson Adams
    Celiac.com 06/14/2018 - Refractory celiac disease type II (RCDII) is a rare complication of celiac disease that has high death rates. To diagnose RCDII, doctors identify a clonal population of phenotypically aberrant intraepithelial lymphocytes (IELs). 
    However, researchers really don’t have much data regarding the frequency and significance of clonal T cell receptor (TCR) gene rearrangements (TCR-GRs) in small bowel (SB) biopsies of patients without RCDII. Such data could provide useful comparison information for patients with RCDII, among other things.
    To that end, a research team recently set out to try to get some information about the frequency and importance of clonal T cell receptor (TCR) gene rearrangements (TCR-GRs) in small bowel (SB) biopsies of patients without RCDII. The research team included Shafinaz Hussein, Tatyana Gindin, Stephen M Lagana, Carolina Arguelles-Grande, Suneeta Krishnareddy, Bachir Alobeid, Suzanne K Lewis, Mahesh M Mansukhani, Peter H R Green, and Govind Bhagat.
    They are variously affiliated with the Department of Pathology and Cell Biology, and the Department of Medicine at the Celiac Disease Center, New York Presbyterian Hospital/Columbia University Medical Center, New York, USA. Their team analyzed results of TCR-GR analyses performed on SB biopsies at our institution over a 3-year period, which were obtained from eight active celiac disease, 172 celiac disease on gluten-free diet, 33 RCDI, and three RCDII patients and 14 patients without celiac disease. 
    Clonal TCR-GRs are not infrequent in cases lacking features of RCDII, while PCPs are frequent in all disease phases. TCR-GR results should be assessed in conjunction with immunophenotypic, histological and clinical findings for appropriate diagnosis and classification of RCD.
    The team divided the TCR-GR patterns into clonal, polyclonal and prominent clonal peaks (PCPs), and correlated these patterns with clinical and pathological features. In all, they detected clonal TCR-GR products in biopsies from 67% of patients with RCDII, 17% of patients with RCDI and 6% of patients with gluten-free diet. They found PCPs in all disease phases, but saw no significant difference in the TCR-GR patterns between the non-RCDII disease categories (p=0.39). 
    They also noted a higher frequency of surface CD3(−) IELs in cases with clonal TCR-GR, but the PCP pattern showed no associations with any clinical or pathological feature. 
    Repeat biopsy showed that the clonal or PCP pattern persisted for up to 2 years with no evidence of RCDII. The study indicates that better understanding of clonal T cell receptor gene rearrangements may help researchers improve refractory celiac diagnosis. 
    Source:
    Journal of Clinical Pathologyhttp://dx.doi.org/10.1136/jclinpath-2018-205023